<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300945
Report Date: 02/05/2025
Date Signed: 02/05/2025 01:16:32 PM

Document Has Been Signed on 02/05/2025 01:16 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MAFIGHOLAMI-BABAEENEZHAD FAMILY CHILD CAREFACILITY NUMBER:
336300945
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
02/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:07 AM
MET WITH:Nazanin Babaeenezhad & Mehrnoush MafigholamiTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/05/25, Licensing Program Analyst (LPA) Kelli Waters arrived unannounced at the facility to conduct an annual inspection as part of a compliance review. Present during the inspection were both Licensees. LPA met with Nazanin Babaeenezhad and Mehrnoush Mafigholami and toured the facility, inside and out, records were reviewed, and the following was observed and/or discussed:

Facility Review:
• Normal days and hours of operation are: Monday-Friday 7am-5pm

• Off-limit areas include: Kitchen, garage, parts of the backyard and entire second floor

• The facility is licensed to have no more than 8 children as a small FCCH and is operating within the licensed capacity and appropriate ratios. 2 staff with 6 children present (3 infants)

• Appropriate supervision was being provided during this inspection

• A working telephone is present, and the current phone number is on file

• A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector and carbon monoxide detector were present and tested by the Licensee during this inspection.

• Fireplace is properly screened to prevent access by children

• All hazardous items are stored inaccessible to children; LPA advised licensees to add additional safety measures for access to areas that are off-limits

• Toxins are locked and inaccessible to children in care.

• Weapons are not present. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations

• Stairs are barricaded

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MAFIGHOLAMI-BABAEENEZHAD FAMILY CHILD CARE
FACILITY NUMBER: 336300945
VISIT DATE: 02/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
•Clean, safe, and age-appropriate toys are provided

• Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights poster are posted; Licensees will update and provide CCLD the most current forms

• Documentation of fire and disaster drills are on file – Last drill was conducted on 01/16/25

• No bodies of water are present at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.


Record Review:
• Verification of control of property is on file

• Current roster on file

• Children’s records are complete

• Mandated Reporter Training expires on 12/25

• Pediatric CPR and First Aid Card expires on 09/25

• Health & Safety Certificate - completed on 10/8/23

• Resident and/or staff records were reviewed and not all adults who require background checks and required health clearances have received all required clearances and/or exemptions. After record review and interview, Adult resident (A1), not present, had a clearance check that was still in process as of the inspection date. A citation will be issued under Title 22 regulations Criminal Record Clearance 102370(a) and a civil penalty will be assessed.


***Licensee was reminded that all adults 18 and over, living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.***
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC809 (FAS) - (06/04)
Page: 2 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MAFIGHOLAMI-BABAEENEZHAD FAMILY CHILD CARE
FACILITY NUMBER: 336300945
VISIT DATE: 02/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Topics Discussed:
• Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/

• LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

• LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

• Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

******************************************************************************************


On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN).

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send them email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC809 (FAS) - (06/04)
Page: 3 of 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MAFIGHOLAMI-BABAEENEZHAD FAMILY CHILD CARE
FACILITY NUMBER: 336300945
VISIT DATE: 02/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200

See LIC809-D for cited deficiencies

During the exit interview, the Licensees Nazanin Babaeenezhad and Mehrnoush Mafigholami, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and this report was reviewed with the Licensee. Appeal rights were discussed and provided during the exit interview.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC809 (FAS) - (06/04)
Page: 4 of 7
Document Has Been Signed on 02/05/2025 01:16 PM - It Cannot Be Edited


Created By: Kelli Waters On 02/05/2025 at 12:19 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MAFIGHOLAMI-BABAEENEZHAD FAMILY CHILD CARE
FACILITY NUMBER: 336300945

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, Adult 1 (A1) moved to the facility prior to the background check being fully cleared and was still in process as of the date of inspection, therefore the licensees did not comply with the section cited above in which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2025
Plan of Correction
1
2
3
4
Adult 1 (A1) will remain out of the facility during childcare hours until background clearance check has been cleared through Guardian. Licensees will follow up with Guardian regarding any items needed to associate A1 to the facility. Licensees will update LPA on status on A1's clearance by POC date.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Carlos Martinez
LICENSING EVALUATOR NAME:Kelli Waters
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2025


LIC809 (FAS) - (06/04)
Page: 7 of 7